Provisions in Medicare now allow aging seniors to “age-in” at home, unless their health condition dictates otherwise. There are two programs designed to help seniors make the choice that is best for them: PACE (Program for all inclusive care for the elderly) and Social Managed care plan. For seniors wanting and able to stay in their homes, PACE is the program worth considering.
PACE is designed to help seniors meet their health needs in their community instead of going into a nursing home or other care facility. Most seniors like the idea of “PACE” but not all are able to receive the care they need through it. The program works to build a team of PACE-preferred doctors along with a team of health care professionals who work with the senior and their family/community to coordinate the care needed.
The following link is the website for PACE (http://www.npaonline.org/website/article.asp?id=4). The site allows you to find the local PACE provider in your area where you can inquire about the program and eligibility requirements (http://www.npaonline.org/custom/programsearch.asp?id=209).
To qualify, you must be:
*55 years or older
*Live in the service area of a PACE organization
*Need a nursing home-level of care (as certified by your state)
*Be able to live safely in the community with help from PACE
Participants are able to leave the PACE program at any time. All of the typical care and services provided by Medicare and Medicaid are recognized through the PACE program, with the possibility some “uncovered” services may be covered with PACE.
Typical coverage includes:
*Adult day primary care (doctor/recreational/therapy nursing services)
*Denistry
*Emergency services
*Home care services
*Hospital care
*Laboratory/x-ray services
*Meals
*Medical specialty services
*Nursing home
*Nutritional counseling
*Occupational therapy
*Physical therapy
*Prescription drugs
According to the program: “If you join a PACE program, you’ll get your Part D-covered drugs and all other necessary medication from the PACE program. You don’t need to join a separate Medicare Prescription Drug Plan. If you do, you’ll be dis-enrolled from your PACE health and prescription drug benefits.”
Other plan benefits include:
*Preventive care
*Social services, including caregiver training, support groups and respite care
*Social work counseling
*Transportation to PACE center for activities or medical appointments, if medically necessary, including possible transportation to some medical appointments in your community.
To apply, contact your state’s Medical Assistance (Medicaid) program. What you “pay” for PACE is based upon your eligibility. According to the program, “If you have Medicaid, you won’t pay a monthly premium for the long-term care portion of the PACE benefit.” Otherwise, you would be charged a monthly premium to cover the long-term care portion of the PACE benefit and a premium for Medicare Part D drugs. If you fall into the category of not having Medicare or Medicaid, then you would pay for PACE privately.
Quick Tips for Wellness: With so many seniors wanting to age gracefully at home, PACE may be a very welcome alternative to other options. Check with your local PACE representative to learn more about this program.
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